Abstract
AbstractHistories of the global smallpox eradication programme have tended to concentrate on the larger national formations in Africa and Asia. This focus is generally justified by chroniclers by the fact that these locations contributed a major share of the world’s annual tally of variola, which meant that international agencies paid a lot of attention to working with officials in national and local government on anti-smallpox campaigns in these territories. Such historiographical trends have led to the marginalisation of the histories of smallpox eradication programmes in smaller nations, which are presented either in heroic, institutional tropes as peripheral or as being largely shorn of sustained campaigns against the disease. Using a case study of Bhutan, a small Himalayan kingdom sandwiched between India and China, an effort is made to reclaim the historical experiences in small national entities in the worldwide smallpox eradication programme. Bhutan’s experience in the 1960s and 1970s allows much more in addition. It provides us with a better understanding of the limited powers of international agencies in areas considered politically sensitive by the governments of powerful nations such as India. The resulting methodological suggestions are of wider historical and historiographical relevance.
Highlights
The worldwide programme to eradicate smallpox started gathering momentum in the latter half of the 1960s, after the creation of an energetic coordinating body at the World Health Organization headquarters in Geneva (WHO HQ)
The West African campaign, which was coordinated by the United States Centers of Disease Control (CDC) and supported by the United States Agency for International Development (USAID), coincided with efforts to crank up the effectiveness of existing smallpox eradication programmes in South Asia
Concerns were raised about the transmission of smallpox from India to Bhutan, and evidence was unearthed locally about a major outbreak in 1966, appeals from the WHO HQ for investigation into these developments were dismissed in New Delhi
Summary
The worldwide programme to eradicate smallpox started gathering momentum in the latter half of the 1960s, after the creation of an energetic coordinating body at the World Health Organization headquarters in Geneva (WHO HQ). The support mobilised ebbed and flowed over time, and this experience presented WHO officials with a steep learning curve, and forced them to face up to several harsh lessons about the complexity of local administration and politics These experiences, as well as the difficulties created by largely autonomous WHO Regional Offices that were divided about the wisdom of providing unquestioning backing to the goal of smallpox eradication, helped Henderson’s unit recognise the need to remain adaptable towards the crystallisation of multifaceted national programmes.[3] This enabled his associates and him to advocate a less top-down style of management, which was welcomed at least by some international workers deployed by the WHO worldwide. It is useful to analyse an expansive set of conversations involving a variety of actors: the smallpox eradication unit within the WHO HQ in Geneva, a group of well-connected medical volunteers based in the USA, the royal court and government of Bhutan in Thimpu, the WHO SEARO offices in New Delhi and, not least, the Indian federal authorities and their representatives in the Himalayan kingdom
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